Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.
ADVANCED SEARCH
Log in
Top
BMC Cancer
Published in: BMC Cancer 1/2016

Open Access 01-12-2016 | Research article

Investigation of optical coherence micro-elastography as a method to visualize micro-architecture in human axillary lymph nodes

Authors: Kelsey M. Kennedy, Lixin Chin, Philip Wijesinghe, Robert A. McLaughlin, Bruce Latham, David D. Sampson, Christobel M. Saunders, Brendan F. Kennedy

Published in: BMC Cancer | Issue 1/2016

Login to get access

Abstract

Background

Evaluation of lymph node involvement is an important factor in detecting metastasis and deciding whether to perform axillary lymph node dissection (ALND) in breast cancer surgery. As ALND is associated with potentially severe long term morbidity, the accuracy of lymph node assessment is imperative in avoiding unnecessary ALND. The mechanical properties of malignant lymph nodes are often distinct from those of normal nodes. A method to image the micro-scale mechanical properties of lymph nodes could, thus, provide diagnostic information to aid in the assessment of lymph node involvement in metastatic cancer. In this study, we scan axillary lymph nodes, freshly excised from breast cancer patients, with optical coherence micro-elastography (OCME), a method of imaging micro-scale mechanical strain, to assess its potential for the intraoperative assessment of lymph node involvement.

Methods

Twenty-six fresh, unstained lymph nodes were imaged from 15 patients undergoing mastectomy or breast-conserving surgery with axillary clearance. Lymph node specimens were bisected to allow imaging of the internal face of each node. Co-located OCME and optical coherence tomography (OCT) scans were taken of each sample, and the results compared to standard post-operative hematoxylin-and-eosin-stained histology.

Results

The optical backscattering signal provided by OCT alone may not provide reliable differentiation by inspection between benign and malignant lymphoid tissue. Alternatively, OCME highlights local changes in tissue strain that correspond to malignancy and are distinct from strain patterns in benign lymphoid tissue. The mechanical contrast provided by OCME complements the optical contrast provided by OCT and aids in the differentiation of malignant tumor from uninvolved lymphoid tissue.

Conclusion

The combination of OCME and OCT images represents a promising method for the identification of malignant lymphoid tissue. This method shows potential to provide intraoperative assessment of lymph node involvement, thus, preventing unnecessary removal of uninvolved tissues and improving patient outcomes.
Literature
1.
Overgaard J. Management of the axilla in breast cancer: Implication for diagnosis, prognosis, treatment, and morbidity. Acta Oncol. 2000;39(3):259–60.CrossRefPubMed
2.
Weigelt B, Peterse JL, van’t Veer LJ. Breast cancer metastasis: Markers and models. Nat Rev Cancer. 2005;5(8):591–602.CrossRefPubMed
3.
Lyman GH, Temin S, Edge SB, Newman LA, Turner RR, Weaver DL, Benson III AB, Bosserman LD, Burstein HJ, Cody III H, et al. Sentinel lymph node biopsy for patients with early-stage breast cancer: American Society of Clinical Oncology clinical practice guideline update. J Clin Oncol. 2014;32(13):1365–83.CrossRefPubMed
4.
Sakorafas GH, Peros G, Cataliotti L. Sequelae following axillary lymph node dissection for breast cancer. Expert Rev Anticancer Ther. 2006;6(11):1629–38.CrossRefPubMed
5.
Valente SA, Levine GM, Silverstein MJ, Rayhanabad JA, Weng-Grumley JG, Ji L, Holmes DR, Sposto R, Sener SF. Accuracy of predicting axillary lymph node positivity by physical examination, mammography, ultrasonography, and magnetic resonance imaging. Ann Surg Oncol. 2012;19(6):1825–30.CrossRefPubMed
6.
Fujii T, Yanagita Y, Kinoshita T, Fujisawa T, Hirakata T, Yamaki S, Matsumoto A, Uchida N, Iijima M, Kuwano H. Accuracy of intraoperative macroscopic diagnosis of sentinel node metastases in breast cancer: Is accurate prediction possible? Tumori. 2011;97(1):62–5.PubMed
7.
Layfield DM, Agrawal A, Roche H, Cutress RI. Intraoperative assessment of sentinel lymph nodes in breast cancer. Br J Surg. 2011;98(1):4–17.CrossRefPubMed
8.
Tanis PJ, Boom RPA, Koops HS, Faneyte IF, Peterse JL, Nieweg OE, Rutgers EJT, Tiebosch ATMG, Kroon BBR. Frozen section investigation of the sentinel node in malignant melanoma and breast cancer. Ann Surg Oncol. 2001;8(3):222–6.CrossRefPubMed
9.
Creager AJ, Geisinger KR, Shiver SA, Perrier ND, Shen P, Shaw JA, Young PR, Levine EA. Intraoperative evaluation of sentinel lymph nodes for metastatic breast carcinoma by imprint cytology. Mod Pathol. 2002;15(11):1140–7.CrossRefPubMed
10.
Fischer U, Zachariae O, Baum F, Heyden D, Funke M, Liersch T. The influence of preoperative MRI of the breasts on recurrence rate in patients with breast cancer. Eur Radiol. 2004;14(10):1725–31.CrossRefPubMed
11.
Diepstraten SCE, Sever AR, Buckens CFM, Veldhuis WB, Dalen T, Bosch MAAJ, Mali WPTM, Verkooijen HM. Value of preoperative ultrasound-guided axillary lymph node biopsy for preventing completion axillary lymph node dissection in breast cancer: A systematic review and meta-analysis. Ann Surg Oncol. 2014;21(1):51–9.CrossRefPubMed
12.
Fuster D, Duch J, Paredes P, Velasco M, Muñoz M, Santamaría G, Fontanillas M, Pons F. Preoperative staging of large primary breast cancer with [18F]fluorodeoxyglucose positron emission tomography/computed tomography compared with conventional imaging procedures. J Clin Oncol. 2008;26(29):4746–51.CrossRefPubMed
13.
Mamou J, Coron A, Oelze ML, Saegusa-Beecroft E, Hata M, Lee P, Machi J, Yanagihara E, Laugier P, Feleppa EJ. Three-dimensional high-frequency backscatter and envelope quantification of cancerous human lymph nodes. Ultrasound Med Biol. 2011;37(3):345–57.CrossRefPubMedPubMedCentral
14.
Luke GP, Myers JN, Emelianov SY, Sokolov KV. Sentinel lymph node biopsy revisited: Ultrasound-guided photoacoustic detection of micrometastases using molecularly targeted plasmonic nanosensors. Cancer Res. 2014;74(19):5397–408.CrossRefPubMedPubMedCentral
15.
Luo W, Nguyen FT, Zysk AM, Ralston TS, Brockenbrough J, Marks DL, Oldenburg AL, Boppart SA. Optical biopsy of lymph node morphology using optical coherence tomography. Technol Cancer Res Treat. 2005;4(5):539–48.CrossRefPubMed
16.
McLaughlin RA, Scolaro L, Robbins P, Hamza S, Saunders C, Sampson DD. Imaging of human lymph nodes using optical coherence tomography: Potential for staging cancer. Cancer Res. 2010;70(7):2579–84.CrossRefPubMed
17.
Nguyen FT, Zysk AM, Chaney EJ, Adie SG, Kotynek JG, Oliphant UJ, Bellafiore FJ, Rowland KM, Johnson PA, Boppart SA. Optical coherence tomography: The intraoperative assessment of lymph nodes in breast cancer. IEEE Eng Med Biol Mag. 2010;29(2):63–70.CrossRefPubMedPubMedCentral
18.
Scolaro L, McLaughlin RA, Klyen BR, Wood BA, Robbins PD, Saunders CM, Jacques SL, Sampson DD. Parametric imaging of the local attenuation coefficient in human axillary lymph nodes assessed using optical coherence tomography. Biomed Opt Express. 2012;3(2):366–79.CrossRefPubMedPubMedCentral
19.
John R, Adie SG, Chaney EJ, Marjanovic M, Tangella KV, Boppart SA. Three-dimensional optical coherence tomography for optical biopsy of lymph nodes and assessment of metastatic disease. Ann Surg Oncol. 2013;20(11):3685–93.CrossRefPubMed
20.
Scolaro L, McLaughlin RA, Kennedy BF, Saunders CM, Sampson DD. A review of optical coherence tomography in breast cancer. Photonics Lasers Med. 2014;3(3):225–40.CrossRef
21.
Grieve K, Mouslim K, Assayag O, Dalimier E, Harms F, Bruhat A, Boccara C, Antoine M. Assessment of sentinel node biopsies with full-field optical coherence tomography. Technol Cancer Res Treat. 2015;15(2):266–74.CrossRefPubMed
22.
Nolan RM, Adie SG, Marjanovic M, Chaney EJ, South FA, Monroy GL, Shemonski ND, Erickson-Bhatt SJ, Shelton RL, Bower AJ, et al. Intraoperative optical coherence tomography for assessing human lymph nodes for metastatic cancer. BMC Cancer. 2016;16:144.CrossRefPubMedPubMedCentral
23.
Miyaji K, Furuse A, Nakajima J, Kohno T, Ohtsuka T, Yagyu K, Oka T, Omata S. The stiffness of lymph nodes containing lung carcinoma metastases. Cancer. 1997;80(10):1920–5.CrossRefPubMed
24.
25.
26.
Glaser KJ, Manduca A, Ehman RL. Review of MR elastography applications and recent developments. J Magn Reson Imaging. 2012;36(4):757–74.CrossRefPubMed
27.
Choi JJ, Kang BJ, Kim SH, Lee JH, Jeong SH, Yim HW, Song BJ, Jung SS. Role of sonographic elastography in the differential diagnosis of axillary lymph nodes in breast cancer. J Ultrasound Med. 2011;30(4):429–36.CrossRefPubMed
28.
Evans A, Rauchhaus P, Whelehan P, Thomson K, Purdie CA, Jordan LB, Michie CO, Thompson A, Vinnicombe S. Does shear wave ultrasound independently predict axillary lymph node metastasis in women with invasive breast cancer? Breast Cancer Res Treat. 2014;143(1):153–7.CrossRefPubMed
29.
Schmitt JM. OCT elastography: Imaging microscopic deformation and strain of tissue. Opt Express. 1998;3(6):199–211.CrossRefPubMed
30.
Kennedy BF, Kennedy KM, Sampson DD. A review of optical coherence elastography: Fundamentals, techniques and prospects. IEEE J Sel Topics Quantum Electron. 2014;20(2):272–88.CrossRef
31.
Wang S, Larin KV. Optical coherence elastography for tissue characterization: A review. J Biophotonics. 2015;8(4):279–302.CrossRefPubMed
32.
Mulligan JA, Untracht GR, Chandrasekaran SN, Brown CN, Adie SG. Emerging approaches for high-resolution imaging of tissue biomechanics with optical coherence elastography. IEEE J Sel Topics Quantum Electron. 2016;22(3):6800520.CrossRef
33.
Kennedy BF, McLaughlin RA, Kennedy KM, Chin L, Curatolo A, Tien A, Latham B, Saunders CM, Sampson DD. Optical coherence micro-elastography: Mechanical-contrast imaging of tissue microstructure. Biomed Opt Express. 2014;5(7):2113–24.CrossRefPubMedPubMedCentral
34.
Kennedy BF, McLaughlin RA, Kennedy KM, Chin L, Wijesinghe P, Curatolo A, Tien A, Ronald M, Latham B, Saunders CM, et al. Investigation of optical coherence micro-elastography as a method to visualize cancers in human breast tissue. Cancer Res. 2015;75(16):3236–45.CrossRefPubMed
35.
Wang RK, Kirkpatrick S, Hinds M. Phase-sensitive optical coherence elastography for mapping tissue microstrains in real time. Appl Phys Lett. 2007;90(16):164105.CrossRef
36.
Deserno TM, editor. Biomedical image processing. Berlin Heidelberg: Springer; 2011.
37.
Lopez JI, Kang I, You W-K, McDonald DM, Weaver VM. In situ force mapping of mammary gland transformation. Integr Biol. 2011;3(9):910–21.CrossRef
38.
Plodinec M, Loparic M, Monnier CA, Obermann EC, Zanetti-Dallenbach R, Oertle P, Hyotyla JT, Aebi U, Bentires-Alj M, Lim RYH, et al. The nanomechanical signature of breast cancer. Nat Nanotechnol. 2012;7(11):757–65.CrossRefPubMed
39.
Weaver DL. Pathology evaluation of sentinel lymph nodes in breast cancer: Protocol recommendations and rationale. Mod Pathol. 2010;23:S26–32.CrossRefPubMed
40.
Li C, Guan G, Huang Z, Johnstone M, Wang RK. Noncontact all-optical measurement of corneal elasticity. Opt Lett. 2012;37(10):1625–7.CrossRefPubMed
41.
Wang S, Lopez III AL, Morikawa Y, Tao G, Li J, Larina IV, Martin JF, Larin KV. Noncontact quantitative biomechanical characterization of cardiac muscle using shear wave imaging optical coherence tomography. Biomed Opt Express. 2014;5(7):1980–92.CrossRefPubMedPubMedCentral
42.
Nguyen T-M, Song S, Arnal B, Huang Z, O’Donnell M, Wang RK. Visualizing ultrasonically induced shear wave propagation using phase-sensitive optical coherence tomography for dynamic elastography. Opt Lett. 2014;39(4):838–41.CrossRefPubMedPubMedCentral
43.
Kennedy KM, Chin L, McLaughlin RA, Latham B, Saunders CM, Sampson DD, Kennedy BF. Quantitative micro-elastography: Imaging of tissue elasticity using compression optical coherence elastography. Sci Rep. 2015;5:15538.CrossRefPubMedPubMedCentral
44.
Dong L, Wijesinghe P, Dantuono JT, Sampson DD, Munro PRT, Kennedy BF, Oberai AA. Quantitative compression optical coherence elastography as an inverse elasticity problem. IEEE J Sel Topics Quantum Electron. 2016;22(3):6802211.CrossRef
45.
Curatolo A, Villiger M, Lorenser D, Wijesinghe P, Fritz A, Kennedy BF, Sampson DD. Ultrahigh-resolution optical coherence elastography. Opt Lett. 2016;41(1):21–4.CrossRefPubMed
46.
Kennedy BF, Malheiro FG, Chin L, Sampson DD. Three-dimensional optical coherence elastography by phase-sensitive comparison of C-scans. J Biomed Opt. 2014;19(7):076006.CrossRefPubMed
47.
Kirk RW, Kennedy BF, Sampson DD, McLaughlin RA. Near video-rate optical coherence elastography by acceleration with a graphics processing unit. J Lightw Technol. 2015;33(16):3481–5.CrossRef
Metadata
Title
Investigation of optical coherence micro-elastography as a method to visualize micro-architecture in human axillary lymph nodes
Authors
Kelsey M. Kennedy
Lixin Chin
Philip Wijesinghe
Robert A. McLaughlin
Bruce Latham
David D. Sampson
Christobel M. Saunders
Brendan F. Kennedy
Publication date
01-12-2016
Publisher
BioMed Central
Published in
BMC Cancer / Issue 1/2016
Electronic ISSN: 1471-2407
DOI
https://doi.org/10.1186/s12885-016-2911-z

Other articles of this Issue 1/2016

BMC Cancer 1/2016 Go to the issue

Research article

Combined chemoradiation of cisplatin versus carboplatin in cervical carcinoma: a single institution experience from Thailand

Research article

High level of serum apolipoprotein A-I is a favorable prognostic factor for overall survival in esophageal squamous cell carcinoma

Research article

Expression of AE1/p16 promoted degradation of AE2 in gastric cancer cells

Debate

TAS-102, the first “cardio-gentle” fluoropyrimidine in the colorectal cancer landscape?

Research article

Five-year disease-free survival among stage II-IV breast cancer patients receiving FAC and AC chemotherapy in phase II clinical trials of Panagen

Research article

Epigenetic silencing of serine protease HTRA1 drives polyploidy
Webinar | 19-02-2024 | 17:30 (CET)

Keynote webinar | Spotlight on antibody–drug conjugates in cancer

Watch now

Antibody–drug conjugates (ADCs) are novel agents that have shown promise across multiple tumor types. Explore the current landscape of ADCs in breast and lung cancer with our experts, and gain insights into the mechanism of action, key clinical trials data, existing challenges, and future directions.

Dr. Véronique Diéras
Prof. Fabrice Barlesi
Developed by: Springer Medicine
Image Credits